Fauci Calls for More Research on HIV-TB Coinfection

Dr. Anthony Fauci, a leading voice for understanding HIV and infectious diseases in the U.S. government for a quarter century, often draws a crowd when he speaks—because of his ability to concisely say what needs to be done. Today, he did just that.

Speaking at a briefing on global HIV-TB issues sponsored by the Center for Global Health Policy today, Fauci highlighted the progress on treatment since 1981. In 1981, he said, the projection for someone diagnosed with HIV was 26 weeks. Today, an HIV-infected 20-year-old appropriately treated with ART can expect to live to age 70 in high-income countries, he added. But, the HIV epidemic still ravages the developing world.

Here are a few statistics Fauci shared showing the need:

Only 30-40% of people in need of ART therapy in low- and middle-income countries are receiving it. This means 60-70% are not.

For every person on ARV therapy in 2008, 2 to 3 others were newly infected with HIV.

Globally, less than one person in 5 at risk of HIV has access to basic HIV prevention services.

“We have many ways to prevent HIV infection,” said Fauci, director of NIH’s National Institute for Allergy and Infectious Disease. “The sobering news is that only 20 percent of people who can benefit actually have access to prevention services. We have the scientific capability but there is an imbalance and a gap on the basis of science and on what we can deliver on the basis of public health.”

And, in contrast to the progress in HIV and AIDS, TB is a different story. Fauci remarked at the lack of progress in tuberculosis during the same time period and the need to play “catch-up.”

“There has been extraordinary inattention paid to bringing the research of TB into the 21st century. I’d be happy if we brought it into the 20th century,” he said.

In his closing, Fauci also pointed to the need for more research on HIV-TB coinfection. Fauci said the sophisticated clinical trial capacity available to address HIV will now be expanded to address the connection between HIV and other illnesses. The first disease that will be looked at in large clinical trials, he added, will be TB.

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